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M.M. Lai, R. Bhisitkul; Retinal Disease Profile Among a Prison Population . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4934.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: The prevalence of health problems among the United States prison population is substantially higher when compared to disease rates of the general population. No studies have been reported describing the retinal disease profile of prisoners. This study was conducted to characterize the retinal disease profile of male prisoners referred to a university-based retina service. Methods: The UCSF computer billing database was queried for all patients seen at the UCSF Retina Service between January, 1999 and June, 2002 with four insurance billing codes corresponding to three intermediate and high security Northern California state prisons. A retrospective review of the demographic data, medical and ophthalmic history, ophthalmic exam, diagnostic study results, and treatment history was conducted for each of these patients. Results: 41 consecutive prisoners were seen during this time period at UCSF. The mean age of prisoners was 47 years. All patients were men. The mean duration of follow-up was 6.26 months. Best corrected visual acuity (BCVA) on initial visit was 20/30 or better in 27 eyes (33%), and worse than 20/200 in thirty-two eyes (39%). Diabetic eye conditions (12 patients, 21 eyes (26%)) and CMV retinitis (10 patients, 12 eyes (15%)) were the most common diagnosis on first visit. 10 eyes (12%) presented with rhegmatogenous retinal detachments. Six patients (15%) described a history of ocular trauma. Of the patients with diabetes, 6 of the 24 eyes (25%) had vitreous hemorrhage, 6 eyes (25%) had tractional retinal detachments, and 5 eyes (20%) had clinically significant macular edema. Of the 12 eyes of patients with CMV retinitis, 5 of the 12 (42%) had a BCVA worse than 20/200. 29 eyes (35%) received some form of therapeutic intervention. The most frequent vitreoretinal procedures performed were pars plana vitrectomies; 13 procedures were performed on 11 eyes. 27% of patients receiving vitrectomy showed improved BCVA. Conclusions: Prisoners were referred to the UCSF retina service with a high proportion of diabetic eye disease, CMV retinitis, ocular trauma, and rhegmatogenous retinal detachments. Ocular pathology was severe overall, as reflected in the poor initial visual acuity, the high rate of surgical interventions required, and the poor visual outcomes achieved. The severity of eye disease in this group may reflect poor control of systemic diseases, ocular trauma, and referral of advanced cases.
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